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01.
medRxiv (Medicine) 2026-06-23

THE SILENT STRUGGLE: EXPLORING THE EFFECTS OF COMMUNICATION BREAKDOWNS IN HEALTHCARE DELIVERY IN THE NORTHERN REGION OF GHANA

Abstract Effective health communication is central to patient-centred care and improved health outcomes, particularly in culturally diverse healthcare settings. In clinical and assistive practice, communication breakdowns may negatively affect diagnosis, treatment adherence, and preventive care. A qualitative phenomenological design was employed, utilizing Semi-Structured interviews with purposively sampled twenty patients and healthcare professionals from Tamale Teaching Hospital, Yendi Hospital, and Bimbilla Hospital. The researchers adopted Content Analysis as the tool of analysis for the data. The findings of this study revealed that language discrepancies Poor attitudes of healthcare providers hinderer patient openness and the quality treatment. Logistical issues, such as inadequate medicines and medical supplies, resulted in delayed treatment and additional financial burden on patients and their relatives. Cultural and social factors discourage patients from discussing certain health conditions with healthcare providers, leading to delayed treatment. These hurdles adversely impact on treatment and assistive practice, specifically in culturally diverse environment and preventive care. The study recommends training and capacity-building programs for healthcare providers in cultural competence, fostering effective and ethical health communication between patients and healthcare providers, and recruiting professional interpreters to bridge the linguistics gap between patients and providers. Abstract Effective health communication is central to patient-centered care and improved health outcomes, particularly in culturally diverse healthcare settings. In clinical and assistive practice, communication breakdowns may negatively affect diagnosis, treatment adherence, and preventive care. A qualitative phenomenological design was employed, utilizing semi-structured interviews with twenty purposively sampled patients and healthcare professionals from Tamale Teaching Hospital, Yendi Hospital, and Bimbilla Hospital. The researchers adopted content analysis as the tool of analysis for the data. The findings of this study revealed that language discrepancies Poor attitudes of healthcare providers hinder patient openness and quality treatment. Logistical issues, such as inadequate medicines and medical supplies, resulted in delayed treatment and additional financial burden on patients and their relatives. Cultural and social factors discourage patients from discussing certain health conditions with healthcare providers, leading to delayed treatment. These hurdles adversely impact treatment and assistive practice, specifically in culturally diverse environments and preventive care. The study recommends training and capacity-building programs for healthcare providers in cultural competence, fostering effective and ethical health communication between patients and healthcare providers, and recruiting professional interpreters to bridge the linguistics gap between patients and providers.

02.
arXiv (CS.AI) 2026-06-24

DynamicPO: Dynamic Preference Optimization for Recommendation

arXiv:2605.00327v3 Announce Type: replace-cross Abstract: In large language model (LLM)-based recommendation systems, direct preference optimization (DPO) effectively aligns recommendations with user preferences, requiring multi-negative objective functions to leverage abundant implicit-feedback negatives and sharpen preference boundaries. However, our empirical analyses reveal a counterintuitive phenomenon, preference optimization collapse, where increasing the number of negative samples can lead to performance degradation despite a continuously decreasing training loss. We further theoretically demonstrate that this collapse arises from gradient suppression, caused by the dominance of easily discriminable negatives over boundary-critical negatives that truly define user preference boundaries. As a result, boundary-relevant signals are under-optimized, weakening the model's decision boundary. Motivated by these observations, we propose DynamicPO (Dynamic Preference Optimization), a lightweight and plug-and-play framework comprising two adaptive mechanisms: Dynamic Boundary Negative Selection, which identifies and prioritizes informative negatives near the model's decision boundary, and Dual-Margin Dynamic beta Adjustment, which calibrates optimization strength per sample according to boundary ambiguity. Extensive experiments on three public datasets show that DynamicPO effectively prevents optimization collapse and improves recommendation accuracy on multi-negative preference optimization methods, with negligible computational overhead. Our code and datasets are available at https://github.com/xingyuHuxingyu/DynamicPO.

03.
arXiv (CS.AI) 2026-06-16

AP-GRPO: Anchor-Gated Phonetic Alignment with Policy Optimization for Pathological Speech Reconstruction

arXiv:2606.15540v1 Announce Type: cross Abstract: Pathological speech from patients with neurodegenerative and neuromotor disorders is often acoustically distorted and linguistically fragmented, making pathological speech reconstruction necessary to recover intended textual content from distorted and incomplete speech recordings. Crucially, such recordings are rarely uniformly degraded: some words or short phrases remain reliable and can serve as audible anchors for reconstructing the corrupted surrounding content. We introduce Anchor-gated Phonetic Group Relative Policy Optimization (AP-GRPO), a GRPO framework with phonetic reward that aligns speech language models (SLMs) through audible-anchor preservation and inter-anchor phonetic compatibility to the original speech signal. AP-GRPO consists of: (i) an anchor-gated reward that matches reliable audible anchors in clear regions; and (ii) an inter-anchor phonetic alignment reward that evaluates whether recovered contents are phonetically supported by the corresponding corrupted inter-anchor speech span. Across four disease conditions, AP-GRPO improves faithful speech reconstruction, and the learned anchor constraint automatically adapts to each condition and thus reveals interpretable disease-specific profiles: conditions with severe articulatory degradation require stronger anchor enforcement, whereas milder impairment or linguistically impaired conditions rely more on phonetic alignment for inter-anchor recovery.

04.
Nature (Science) 2026-06-10

Amplified Arctic iceberg traffic reshapes benthic biodiversity

The Arctic is undergoing rapid warming, resulting in retreating sea ice and glaciers1, yet how cryospheric changes propagate into the deep ocean remains poorly understood2. Here we identify a climate-driven mechanism linking accelerating glacier disintegration to an increase in deep-sea hard-bottom habitats far beyond calving fronts. Seafloor observations in Fram Strait show a localized increase in the density and patchiness of dropstones delivered by debris-laden icebergs. At the same time, four decades of shipboard records show that the occurrence of icebergs increased abruptly in the early 2000s. Backtracking links these icebergs to the main outlet glaciers in northeast Greenland and the Russian High Arctic. In northeast Greenland, the timing of glacier destabilization coincides with this rise, whereas sparse satellite coverage in the Russian sector limits temporal attribution despite indications of enhanced glacier activity. A model sensitivity study shows that, apart from intensified calving, a more dynamic sea ice cover enhances downstream transport of glacial ice. Along these pathways, increased iceberg activity could reshape deep-sea habitats through enhanced melt and associated lithogenic input, and elevate navigational hazards as maritime traffic expands in the Arctic. Although modest compared with the iceberg discharges of Pleistocene Heinrich events, this mechanism provides a modern analogue of long-range cryospheric influence on the seafloor in a warming climate. Accelerated Arctic glacier disintegration and a more dynamic sea ice cover are increasing iceberg-delivered dropstones in the deep ocean, reshaping seafloor habitats and extending cryospheric impacts far beyond glaciers.

05.
arXiv (CS.CV) 2026-06-16

ATV-Net: Adaptive Triple-View Network with Dynamic Feature Fusion

Recent advances in semantic segmentation rely heavily on attention-based and transformer-style architectures that, while accurate, introduce considerable architectural complexity and computational cost. This paper asks whether a compact CNN-based segmentation head can remain competitive by adaptively selecting useful receptive-field evidence. We propose ATV-Net, an Adaptive Triple-View Network that attaches a lightweight head to a conventional backbone. The head organizes three complementary views – point-wise, neighborhood-level, and enlarged context – and fuses them through an Adaptive Decision Gate that generates image-dependent weights from global feature statistics. This allows the model to emphasize different receptive-field responses according to scene content, without dense attention or multi-scale aggregation. Experiments on Cityscapes and Pascal VOC 2012 show that ATV-Net achieves 80.31% mIoU on Cityscapes with ResNet-101 and 80.90% with ConvNeXt-Tiny, and 86.7% and 88.5% mIoU on Pascal VOC 2012, respectively, while requiring fewer GFLOPs than representative context-aggregation and attention-based heads. The results indicate that adaptive receptive-field selection remains a practical and effective design choice for CNN-based semantic segmentation.

06.
arXiv (CS.LG) 2026-06-16

Schattor: Schatten-family methods for deep learning optimization

arXiv:2606.15702v1 Announce Type: cross Abstract: Modern deep learning optimization features heterogeneous parameter structures, noisy gradients, and highly nonconvex landscapes, posing significant challenges for both algorithm design and theoretical analysis. Motivated by the limitations of SGD and the success of adaptive optimizers, we propose {\it Schattor}, a family of adaptive first-order methods based on Schatten norms. Schattor unifies SGD and the recently proposed matrix-variate adaptive optimizer Muon within a single Schatten-norm-based framework. We establish dimension-free stationarity guarantees for methods in the Schattor family for stochastic matrix optimization problems via a novel matrix martingale moment bound. We also develop multi-block extensions that adaptively balance block-wise optimization progress and prove dimension-free stationarity guarantees in this more general setting.

07.
arXiv (CS.LG) 2026-06-15

Realizing Native INT8 Compute for Diffusion Transformers on Consumer GPUs: A Fused INT8 GEMM Kernel for Ideogram 4.0

arXiv:2606.14598v1 Announce Type: new Abstract: Post-training INT8 (W8A8) quantization of diffusion transformers is widely deployed as a speed optimization, yet on consumer Ampere GPUs it is frequently slower than the FP8 and NF4 alternatives it is meant to beat. We trace this to a software artifact: the production "INT8" forward quantizes weights and activations only to immediately dequantize them back to bf16 and run a bf16 matrix multiply, never engaging the GPU's INT8 tensor cores, so the hardware's compute advantage is left entirely unrealized. We close this gap with a single fused Triton INT8 GEMM (int8xint8->int32 on Ampere tensor cores, with per-token x per-channel dequantization and bias folded into the epilogue, autotuned per GEMM shape) dropped into the Ideogram 4.0 diffusion transformer's linear layers in place of the dequantize-to-bf16 path. In the kernel, the int8xint8->int32 accumulation is bit-exact against torch._int_mm and the dequantized output matches the reference at cosine similarity 1.0 with no NaNs, running 2.8-4.2x faster than bf16 per GEMM. End to end it delivers a ~1.1x (~9-10%) speedup at 768px, and at 1024px it generates an image in 156.5 s on a single RTX 3090, faster than the single-card NF4 (164.5 s) and FP8 (172.9 s) baselines, at no measurable quality cost on these point estimates (PickScore/CLIPScore). INT8 thus goes from the slowest variant to the fastest, and 1024px becomes single-GPU feasible. The primary speed criterion (beat FP8, by ~9.5%) is comfortably met; the NF4 margin (~4.9%, single-run n=4) is within run-to-run variance we did not quantify and is best read as consistent with meeting the stretch target. We close with an honest deployment map: the win is specific to consumer Ampere, and on A100 and B200 the same kernel loses to those cards' fast native bf16/FP8 paths.

08.
arXiv (CS.LG) 2026-06-11

APEX: A Network-Native Time-Series Foundation Model for Forecasting and Anomaly Detection for Wireless Edge Operations

arXiv:2606.11553v1 Announce Type: new Abstract: Generic time-series foundation models transfer poorly to wireless network telemetry whose signals are bursty, zero-inflated, and coupled across protocol layers. We present APEX, a network-native, decoder-only transformer for forecasting enterprise AP telemetry, and evaluate it on DHCP degradation as a representative network task. APEX is pre-trained on 10-channel multivariate telemetry from ~4,500 production wireless networks (~100K AP time series, 34 metrics per AP), and is available as APEX-Large (269M, cloud) and APEX-Edge (10.5M, edge). On a 192-step (4-day) DHCP degradation benchmark, APEX-Large reduces MAE by 18% over the strongest foundation-model baseline (Toto) and 38% over SARIMA, with anomaly-detection F1 = 0.93, while APEX-Edge enables sub-second, privacy-preserving inference on AP-class edge hardware. These results suggest network-native pre-training is a practical foundation for proactive wireless operations.

09.
arXiv (CS.AI) 2026-06-15

Dense Coordinate-List Fine-Tuning Induces a Controllable Interference Surface in Vision-Language Models

arXiv:2606.14507v1 Announce Type: new Abstract: Fine-tuning vision-language models to emit dense coordinate lists improves visual grounding but also changes how models serialize, repeat, and terminate structured outputs. We study this behavior as a generation and control surface. In Gemma 4 12B, high-capacity q/k/v/o LoRA raises class-aware F1@0.3 from 0.007 to 0.448 while inducing repeated-tail pressure (duplicate rate 0.080, max repeat 23). A q/v rank sweep keeps max repeat at 21-22 across ranks 4-64, showing capacity persistence. The target signal is separable: object-level repeat-stop removes exact repeated records (duplicate rate 0.000, max repeat 1) while preserving F1 (0.494 to 0.490) and stricter F1@0.5 (0.381 to 0.385). Structure-axis probes localize the effect to bbox-coordinate object lists; dense non-bbox and spatial/count JSON remain repeat-clean, including under high-capacity adapters. Qwen3-VL-8B reproduces a clean controlled endpoint (F1@0.3 0.318, duplicate rate 0.000), and COCO 2017 reproduces acquisition plus duplicate pressure. Dense coordinate-list adaptation therefore creates a structure-bound, cross-family interference surface that can be measured and controlled.

10.
arXiv (quant-ph) 2026-06-17

DRAG-Compatible Leakage Suppression in Landau–Zener Control via Isoprobability Twins

arXiv:2506.19572v4 Announce Type: replace Abstract: Analytically solvable models – particularly the Landau-Majorana-Stückelberg-Zener (LMSZ) and Allen-Eberly-Hioe (AEH) models – underpin many quantum-gate implementations and population-transfer protocols. However, their canonical pulse shapes are incompatible with modern leakage-suppression techniques and some systems. Most notably, the constant Rabi envelope of the LMSZ pulse prevents many leakage-suppression approaches, which require smoothness. We address both limitations by developing the concept of isoprobability twin models: distinct pairs of Rabi frequency $\Omega(t)$ and detuning $\Delta(t)$ that yield identical post-pulse transition probabilities based on the Delos-Thorson transformation. In this work, we formalise the method by experimentally demonstrating the equivalence of multiple LMSZ and AEH twin models on IBM's ibm_kyiv processor. Finally, we show a staggering leakage reduction by more than 3 orders of magnitude using a custom DRAG implementation of a cosine LMSZ isoprobability model.

11.
medRxiv (Medicine) 2026-06-16

The biological clock of multimorbidity: temporal dynamics of disease co-occurrence in primary care

Multimorbidity is the dominant clinical reality of primary care, yet the temporal dynamics governing when and how persistent comorbidity associations emerge remain poorly characterised. Most large-scale comorbidity studies adopt a single observation window after an index diagnosis, implicitly assuming that associations detectable at one year are equally detectable at five. Using 11 years of electronic health records from 5,821,197 individuals in Catalan primary care, we applied a matched cohort design across nine complementary follow-up windows, five cumulative (0-1 to 0-5 years) and four conditional (1-2 to 4-5 years), to 1,315 index diseases, identifying 144,030 significant directed comorbidity associations in the five-year network. We found that 60.1% of these associations required at least three years of follow-up and were undetectable in shorter-window analyses, demonstrating that observation window length is a primary determinant of which comorbidities can be observed. To organise this temporal heterogeneity, we introduce the biological clock of multimorbidity: a two-dimensional framework that positions ICD-10 disease categories according to their rates of cumulative signal attenuation and the persistence of conditional risk. This framework identifies four reproducible temporal patterns (episodic, chronic stable, chronic progressive, and transient-persistent) that are robust under bootstrap resampling, leave-one-disease-out sensitivity analysis, and alternative clustering approaches. The biological clock is systematically modulated by sex, with Blood/Immune and Musculoskeletal disorders showing the largest sex differences in temporal dynamics. Network analysis identified 19 disease "initiators" that generate broad downstream comorbidity burdens and 21 "sinks" representing convergent endpoints of multiple disease trajectories. Comparison with hospital-based Danish data from 6,909,676 individuals showed that shared associations were 2.7-fold enriched over chance expectation (hypergeometric test, p

12.
arXiv (CS.CV) 2026-06-24

3D Masked Autoencoders are Robust Learners of Volumetric and Multimodal Cellular Representations for Microscopy

Self-supervised learning in fluorescence microscopy often relies on 2D projections, despite the inherently three-dimensional nature of cells. We present a systematic comparison of 2D and 3D masked autoencoders (MAE-2D vs. MAE-3D) on volumetric microscopy data. Under matched architectures and training protocols, MAE-3D consistently outperforms 2D max-projection and slice-based variants on downstream single-cell tasks. We further align visual representations with a pretrained protein language model (ESM2) and show that cross-modal supervision yields larger gains for volumetric models. Channel cross-attention and frequency-domain regularization are critical for leveraging 3D spatial context. On a protein–protein interaction task, MAE-3D achieves a ROC–AUC of 0.865, outperforming prior methods by up to +0.025. For protein localization, our best 3D model attains state-of-the-art AUC$_{micro}$ (0.952) and F1$_{micro}$ (0.742), improving over previous approaches by +0.003 and +0.010 absolute, respectively. Overall, these results demonstrate the advantages of native 3D modeling and multimodal alignment for representation learning in single-cell microscopy.

14.
arXiv (CS.CV) 2026-06-17

A Benchmark for Omni-Modal Reasoning in Long Videos

Long-form omni-modal video understanding requires integrating vision, speech, and ambient audio with coherent long-context reasoning. Existing video benchmarks often trade off temporal scale, modality coverage, open-ended interaction, and interpretable scoring. To address this gap, we introduce LongShOTBench, a long video understanding benchmark designed around three coupled goals: holistic omni-modal integration, intent-driven open-ended interaction, and rubric-level diagnosis. It builds single- and multi-turn questions from real viewing scenarios, with systematic tasks probing visual, speech, ambient-audio, temporal, and cross-modal reasoning. Each item includes a reference answer and a weighted criterion-level rubric, letting evaluation identify which perceptual facts, temporal links, modality-grounding requirements, and reasoning steps are satisfied or missed. All samples are manually verified to improve grounding, clarity, and rubric reliability. We also introduce LongShOTAgent, a training-free omni-modal evidence-seeking agent coupling full-video preprocessing with targeted retrieval, query-adaptive segment refinement, and explicit claim verification over visual, speech, and non-speech audio evidence. Its iterative search-refine-verify loop exposes intermediate evidence and lets modality-specific specialists re-analyze relevant moments before answering. We evaluate 105 video-capable models spanning open-source omni-modal models, vision-language systems, audio LLMs, agentic pipelines and closed-source APIs. Current MLLMs remain far from saturating LongShOTBench, while our LongShOTAgent is the strongest training-free system, reaching 66.64% overall. By releasing the benchmark, leaderboard, and method, we provide a shared, interpretable testbed for advancing long-form omni-modal video reasoning. Code, data, and the leaderboard are available at https://longshot.cvmbzuai.com/.

15.
arXiv (CS.LG) 2026-06-12

Adaptive Model-Predictive Control of a Soft Continuum Robot Using a Physics-Informed Neural Network Based on Cosserat Rod Theory

arXiv:2508.12681v3 Announce Type: replace-cross Abstract: Dynamic control of soft continuum robots (SCRs) holds great potential for expanding their applications, but remains a challenging problem due to the high computational demands of accurate dynamic models. While data-driven approaches like Koopman-operator-based methods have been proposed, they typically lack adaptability and cannot reconstruct the full robot shape, limiting their applicability. This work introduces a real-time-capable nonlinear model-predictive control (MPC) framework for SCRs based on a domain-decoupled physics-informed neural network (DD-PINN) with adaptable bending stiffness. The DD-PINN serves as a surrogate for the dynamic Cosserat rod model with a speed-up factor of up to 44,000. It is also used within an unscented Kalman filter for estimating the model states and bending compliance from end-effector position measurements. We implement a nonlinear evolutionary MPC running at 70 Hz on the GPU. In simulation, it demonstrates accurate tracking of dynamic trajectories and setpoint control with end-effector position errors below 3 mm (2.3\% of the actuator's length). In real-world experiments, the controller achieves similar accuracy and accelerations up to 3.55 m/s2.

16.
bioRxiv (Bioinfo) 2026-06-13

ProtAff: Protein Binding Affinity Prediction via LoRA-Finetuned ESM-2

Predicting the binding affinity of protein–protein interactions remains a central challenge in computational biology. Structure prediction models such as AlphaFold3 (AF3) and Boltz-2 can produce high-quality docking poses, and their confidence scores indicate structure quality, but these same scores fail to rank binding affinity among confirmed binders. Here we present ProtAff, a sequence-only affinity prediction model built on ESM-2 (650M parameters) with low-rank adaptation (LoRA) fine-tuning and a cross-attention module. ProtAff is trained using a margin ranking loss on 362,567 affinity measurements spanning 20 heterogeneous data sources, and we removed all training samples whose target sequence exceeds 50% similarity to the test target EGFR. On the AdaptyvBio EGFR benchmark (N = 55), ProtAff achieves a Spearman correlation coefficient {rho} = 0.413, outperforming the best AF3 metric ({rho} = 0.054), the best Boltz-2 metric ({rho} = -0.046), and ML-based predictors MINT ({rho} = 0.242) and CrossAffinity ({rho} = 0.216). Applied to the AdaptyvBio Nipah virus binder design competition, a pipeline incorporating ProtAff for affinity ranking produced a design with KD = 0.132 nM (2 of 5 designs confirmed binding), a 2.8-fold improvement over the competition winner. On a cross-target discrimination benchmark of 91 VHH-antigen crystal structures, ProtAff underperforms structural methods for distinguishing cognate from non-cognate pairings, indicating that sequence-based affinity models are effective for within-target ranking but not for cross-target specificity.

17.
arXiv (CS.AI) 2026-06-24

Detecting AI Coding Agents in Open Source: A Validated Multi-Method Census of 180 Million Repositories

arXiv:2606.24429v1 Announce Type: cross Abstract: Generative AI coding agents are entering the open-source supply chain, yet their diverse and often invisible traces leave their prevalence poorly understood. We introduce a multi-layered detection framework that integrates configuration-file scanning, commit-message analysis, author-identity matching, and bot-signature lookup across World of Code (180M+ Git repositories), classifying agent traces into four behavioral types. No single method captures more than a fraction of activity: multi-method detection identifies 850,157 Claude Code commits in one snapshot, of which bot-account lookup_the signal most adoption studies rely on_recovers only 28,154 (3.3%), a 30x relative-recall gap, so single-signal prevalence estimates are biased low by at least this factor. Every detection pattern is hand-validated (495 labels) with per-cell precision and Wilson confidence intervals. Across snapshots from December 2024 to April 2026, commit-attributed agents generate over 320,000 commits per month; Claude Code leads (886,122 commits across 17,295 projects) and dominates silent, configuration-file-only adoption (21,078 projects). Compared against an independent pull-request census (AIDev), the two channels capture nearly disjoint agent populations_a PR census misses 79% of commit-detected Claude Code adopters and essentially all Codex adopters_and different kinds of work: PR-deployed cloud agents (Codex, Cursor) surface as feature work, while commit-deployed in-editor agents (Claude Code, OpenHands, Aider) surface as maintenance. The observed work profile follows deployment and detection mode rather than the tool itself, so no single channel is representative.

18.
arXiv (CS.CV) 2026-06-16

V2P-Manip: Learning Dexterous Manipulation from Monocular Human Videos

Achieving autonomous robotic dexterous manipulation requires precise, human-like action sequences at scale. As a scalable supplement to costly teleoperation data, extracting trajectories with both visual fidelity and physical plausibility from monocular videos represents a promising frontier in embodied AI. To this end, we introduce V2P-Manip, an efficient framework designed to learn dexterous manipulation policies directly from human demonstration videos. We establish an efficient, integrated pipeline encompassing 3D asset acquisition, trajectory estimation, and dexterous policy learning. To bridge the gap between visual perception and physical constraints, we introduce a two-stage refinement process to enforce spatial alignment and physical consistency. Evaluations on the TACO and OakInk benchmarks demonstrate that our approach significantly outperforms previous methods in pose accuracy, adaptability to unstructured environments, and training efficiency. Ultimately, experimental results confirm an average success rate of over 75% across multiple synthetic manipulation tasks and validate the adaptability of the extracted manipulation priors across diverse dexterous hand embodiments.

19.
medRxiv (Medicine) 2026-06-23

Respiratory support with Continuous Positive Airway Pressure in preterm neonates: an analysis of coverage and quality of care in 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania implementing with the NEST360 Alliance

Background: Prematurity is the leading cause of child deaths worldwide, with the highest neonatal mortality in sub Saharan Africa. Respiratory distress syndrome (RDS) is the leading mortality pathway in preterm neonates, but continuous positive airway pressure (CPAP) has high impact. This analysis reports CPAP coverage and quality of care for preterm neonates admitted to 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania. Methods: Analyses used individually linked neonatal inpatient data and cross-sectional health systems data. All admitted neonates were eligible for inclusion (January 2021 through December 2024). Service readiness for CPAP delivery and mean CPAP coverage were described for CPAP eligible newborns (weighing 1500g). Quality of care cascades were constructed to illustrate key indicators. Survival among CPAP eligible neonates was analysed using regression models, stratified by clinical severity scores. Results: 375,255 newborn admissions were analysed in 66 neonatal units. Functional CPAP availability varied with median 16% of days (IQR: 4 to 47%) classified as high demand (>1.5 eligible newborns per CPAP). Of 64,761 CPAP eligible neonates, 22,006 (34%, 95% CI 33 to 34%) received CPAP. All countries showed improvement in CPAP coverage, with Tanzanian hospitals recording 63% increase in mean coverage (p-value=0.001) over time. Quality of care cascades showed treatment was initiated 1 day for 42% (95% CI 41 to 43%) of eligible neonates receiving CPAP. Only 10% of neonates

20.
medRxiv (Medicine) 2026-06-11

Maternal deaths associated factors in the Conflict-Affected North West Region of Cameroon. Lessons from a cross-sectional survey

Background Maternal mortality is a significant global public health crisis, particularly in sub-Saharan Africa and conflict-affected regions. Cameroon's maternal mortality ratio is high at 406 deaths per 100,000 live births, while the ongoing Anglophone conflict has further exacerbated maternal healthcare delivery in the North West Region (NWR){middle dot} Despite the evidence-based interventions like partographs, obstetric kits, birth preparedness plans, and active management of the third stage of labour, implementation gaps persist across health facilities. Objective The study aimed to assess factors related to preventable maternal deaths in the NWR of Cameroon by exploring maternal health service usage, implementation of obstetric measures, demand-side challenges, accessibility barriers, and health system weaknesses. Methodology The study employed a quantitative descriptive cross-sectional survey design{middle dot} Data was collected with structured questionnaires from postpartum women and healthcare workers in selected health facilities and catchment communities in the NWR{middle dot} Also, a multistage sampling technique was adopted, and Cochran's formula generated a sample size of 109 respondents{middle dot} In addition, data were analysed using SPSS version 27 and Stata version 18, employing descriptive and inferential statistics. Results In this study, while 70{middle dot}64 percent of females attended at least 4 ANC visits, only 38{middle dot}53 percent met WHO ANC adequacy requirements. Facility delivery was 96{middle dot}33 percent, yet only 38{middle dot}46 percent received completed delivery plans. Conflict-related challenges affected access, with 44{middle dot}95 percent reporting insecurity-associated movement difficulties, while 44{middle dot}95 percent reported increased transportation expenses due to the conflict. Near-miss complications were reported among 27.52 percent of participants. Delivery record reviews indicated that obstetric kits were utilised in 81{middle dot}76 percent of deliveries, partographs were accessible in 86{middle dot}49 percent of records but correctly filled in just 60{middle dot}81 percent , while oxytocin administration was 95{middle dot}95 percent. Integrated Health Centres showed poorer adherence with intrapartum interventions compared with District and Regional Hospitals (p

21.
arXiv (CS.CL) 2026-06-15

Chronological Thinking in Full-Duplex Spoken Dialogue Language Models

Recent advances in spoken dialogue language models (SDLMs) reflect growing interest in shifting from turn-based to full-duplex systems, where the models continuously perceive user speech streams while generating responses. This simultaneous listening and speaking design enables real-time interaction and the agent can handle dynamic conversational behaviors like user barge-in. However, during the listening phase, existing systems keep the agent idle by repeatedly predicting the silence token, which departs from human behavior: we usually engage in lightweight thinking during conversation rather than remaining absent-minded. Inspired by this, we propose Chronological Thinking, an on-the-fly conversational thinking mechanism that aims to improve response quality in full-duplex SDLMs. Specifically, chronological thinking presents a paradigm shift from conventional LLM thinking approaches, such as Chain-of-Thought, purpose-built for streaming acoustic input. (1) Strictly causal: the agent reasons incrementally while listening, updating internal hypotheses only from past audio with no lookahead. (2) No additional latency: reasoning is amortized during the listening window; once the user stops speaking, the agent halts thinking and begins speaking without further delay. Experiments demonstrate the effectiveness of chronological thinking through both objective metrics and human evaluations show consistent improvements in response quality. Furthermore, chronological thinking robustly handles conversational dynamics and attains competitive performance on full-duplex interaction metrics.

22.
arXiv (CS.AI) 2026-06-19

Wisdom of Committee: Diverse Distillation from Large Foundation Models and Domain Experts

arXiv:2402.14035v4 Announce Type: replace-cross Abstract: Knowledge distillation from foundation models to compact domain models is challenging due to substantial gaps in capacity, architecture, and modality. For example, in our experiments, distilling from a 76M-parameter language model to a 2M-parameter recommender closes less than 40% of the performance gap between the undistilled student and the teacher. We show that introducing domain-specific experts – which share the student's architectural characteristics – alongside the foundation model as a diverse teacher committee significantly improves transfer. However, standard multi-teacher methods fail to exploit this diversity: naively combining heterogeneous teachers can degrade performance below single-teacher distillation. To address this, we propose DiverseDistill, an interactive distillation framework that employs a learnable Question-Answer mechanism to generate teacher-conditioned queries and align heterogeneous teacher outputs into the student's representation space. Unlike methods requiring gradient-based co-optimization or architectural modification of teachers, DiverseDistill operates with frozen teachers using only forward-pass inference through their intermediate layers: no parameter updates, no co-training, and no architectural surgery. A dynamic teacher importance mechanism further reduces training cost by filtering low-relevance teachers per sample (e.g., ~30% fewer forward passes with no quality loss for recommendation tasks), while the entire Distillation Module is discarded after training, adding zero inference overhead. Evaluations on recommendation (38x compression) and vision (3.6x compression) tasks demonstrate that DiverseDistill recovers 73-114% of the teacher-student performance gap, consistently outperforming all single- and multi-teacher baselines.

23.
arXiv (quant-ph) 2026-06-19

Ultrafast nonadiabatic dynamics of tetraphenylsubstituted nitrogen-based heterocycles

arXiv:2604.16897v2 Announce Type: replace-cross Abstract: Tetraphenylpyrazine (TPP) and 2,3,4,5-tetraphenyl-1H-pyrrole (TePP) are closely related heterocycles bearing four phenyl substituents, whose structural similarity makes them a useful pair for comparing how intramolecular flexibility influences excited-state relaxation and emission in the gas phase and in the solid state. TPP is a prototypical solid-state luminescence enhancement (SLE) emitter, exhibiting a markedly increased quantum yield upon molecular aggregation. In contrast, TePP displays similar quantum yields in solution and solid state, characteristic of dual-state emission (DSE). This behaviour indicates that intramolecular rotations are already significantly hindered in the isolated-molecule regime, consistent with our previous observations for TPP and other solid-state emitters (Hernández-Rodríguez et al., ChemPhysChem, 2024, 25, e202400563). To unravel the excited-state dynamics underlying this contrasting behaviour, we performed mixed quantum-classical trajectory simulations on a single molecule of TPP and TePP employing the surface-hopping method. Twelve singlet states were included at the TD-B3LYP-D3/def2-SVP level, which were previously benchmarked against coupled cluster methods. Simulated observables such as gas phase ultrafast electron diffraction (GUED) and time-resolved fluorescence (TR-FL) signals allow us to dissect the distinct deactivation pathways operating in both systems in the gas phase, while also providing mechanistic insight into how these pathways are expected to evolve in solution and solid-state environments.

24.
arXiv (CS.AI) 2026-06-16

SPRI: SVD-Partitioned Residual Initialization for Data-Constrained MoE Upcycling

arXiv:2606.16456v1 Announce Type: cross Abstract: Mixture-of-Experts (MoE) models enable efficient scaling, but training them from scratch remains prohibitively expensive. MoE upcycling mitigates this cost by converting pretrained dense models into sparse MoE models. However, existing upcycling methods typically rely on large-scale continued training and often perform poorly under data-constrained supervised adaptation, due to either homogeneous experts or overly disruptive perturbations to pretrained parameters. In this setting, effective upcycling must leverage pretrained weight structure while introducing sufficient diversity among routed experts. To this end, we propose SVD-Partitioned Residual Initialization (SPRI), which distributes SVD-partitioned residuals derived from pretrained feed-forward network (FFN) weights across routed experts, introducing controlled expert diversity grounded in pretrained spectral structure. We further introduce a two-stage training strategy to improve adaptation stability. We evaluate SPRI on multilingual speech-to-text translation, where limited supervised data challenges MoE upcycling and multiple target languages provide natural routing heterogeneity. On CoVoST2 across 15 En-to-XX directions, SPRI improves average BLEU and COMET over fully fine-tuned dense models by 2.58 and 3.32 points, respectively, and outperforms the prior best MoE upcycling baseline by 3.39 BLEU and 4.34 COMET points.

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PLOS Medicine 2026-05-13

Contribution of nosocomial transmission to <i>Klebsiella pneumoniae</i> neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data

by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng-Nkrumah, David Ojok, Boaz D. Wadugu, Andrew C. Whitelaw, Anudita Bhargava, Atul Jindal, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt Background Klebsiella pneumoniae is the leading cause of sepsis among neonates in low- and middle-income countries (LMICs) in Africa and Asia, contributing substantially to the overall burden of antimicrobial-resistant infections and mortality among neonates globally. Pathogen sequencing has been used to investigate case clusters and confirm nosocomial transmission in a small number of neonatal units. Here we utilise pathogen sequence data to estimate the fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission in African and South Asian countries. Methods and findings We estimated the proportion of invasive K. pneumoniae disease involved in nosocomial transmission clusters in a given neonatal unit, using single-linkage clustering based on pairwise temporal and genetic distances estimated from bacterial whole-genome sequences aggregated from 10 contributing studies. Analysing 1,523 K. pneumoniae isolates from 27 units in 13 countries in Africa and South Asia between 2013 and 2023, we inferred 156 nosocomial transmission clusters, ranging from 2 to 188 neonates each (83 of the clusters comprised ≥3 cases). Overall, we estimated that 1,035 neonatal infections (68.0%) were part of nosocomial transmission clusters. Excluding the first infection in each cluster as a potential index case, we estimate at least 879 (57.7%) infections were acquired via nosocomial transmission. Sensitivity analyses showed that results were robust to the choice of genetic distance estimation methods and thresholds used to define clusters, and cluster estimates were stable over temporal distance thresholds ranging from 2 to 8 weeks. Isolates were mostly extended-spectrum beta-lactamase (ESBL) producers (90.9%) and included 172 multi-locus sequence types (STs). Fourteen STs, including several globally recognised multidrug-resistant lineages, were associated with transmission clusters at multiple units, and these were collectively responsible for two-thirds of all infections. Carriage of carbapenemase genes (adjusted odds ratio, aOR = 2.08 [95% confidence interval, CI: 1.04, 4.14]; p = 0.04) and ESBL genes (aOR = 2.48 [95% CI: 1.26, 4.90]; p = 0.006) were significantly positively associated with transmission in a logistic regression model with site as a covariate. Limitations of this study include the lack of sufficient clinical data to allow high-resolution investigation of transmission dynamics and lack of facility-level data to investigate contributors to the observed differences in transmission burden across sites. Conclusions Nosocomial transmission contributes to a substantial proportion of K. pneumoniae sepsis in neonatal care units in Africa and South Asia. Reducing transmission within these settings through improved infection prevention and control and other measures could substantially reduce the neonatal sepsis burden. A high burden of transmission clusters is associated with the same drug-resistant lineages that are recognised as high-risk clones associated with hospital outbreaks in high-income countries, indicating global connectivity of the antimicrobial-resistant pathogen population.